A retrospective study of insurance coverage status and economic cost of rare diseases in Hainan Province

Abstract Rare diseases present a significant economic burden on patients, families, and healthcare systems worldwide. As the prevalence of these diseases rises in China, data regarding their impact, specifically in Hainan Province, is scarce. Thus, this study aims to evaluate insurance coverage, eco...

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Main Authors: John Sieh Dumbuya, Xiuling Chen, Lin Deng, Bashir Ahmad, Jun Lu
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-97836-0
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author John Sieh Dumbuya
Xiuling Chen
Lin Deng
Bashir Ahmad
Jun Lu
author_facet John Sieh Dumbuya
Xiuling Chen
Lin Deng
Bashir Ahmad
Jun Lu
author_sort John Sieh Dumbuya
collection DOAJ
description Abstract Rare diseases present a significant economic burden on patients, families, and healthcare systems worldwide. As the prevalence of these diseases rises in China, data regarding their impact, specifically in Hainan Province, is scarce. Thus, this study aims to evaluate insurance coverage, economic costs, and the factors contributing to the burden of rare diseases in Hainan. We employed a bottom-up approach to analyse the prevalence and economic burden from 2019 to 2023, utilising data from the Hainan Provincial Health Commission Databases. We assessed insurance coverage as well as expenditures related to hospitalisation, diagnostics, medications, surgery, and out-of-pocket costs. Of 4,975 patients diagnosed with 99 distinct rare diseases, 83.01% were insured. From 2019 to 2023, the number of patients increased from 760 to 1,328, while economic costs surged from 34.26 million CNY (US$ 4.89 million) to 64.74 million CNY (US$ 8.86 million). Thalassemia major, one of the most prevalent conditions, generated the highest costs. Hospitalisation expenses accounted for 49.16% of the total costs, with out-of-pocket expenses averaging 17.52%. The findings reveal a significant economic burden associated with rare diseases in Hainan, highlighting the necessity for targeted policy interventions. Furthermore, additional research is needed to refine estimates of this economic burden.
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spelling doaj-art-7cc33e7d0d764a0aa29f872e0fdbbc032025-08-20T03:18:53ZengNature PortfolioScientific Reports2045-23222025-04-0115111510.1038/s41598-025-97836-0A retrospective study of insurance coverage status and economic cost of rare diseases in Hainan ProvinceJohn Sieh Dumbuya0Xiuling Chen1Lin Deng2Bashir Ahmad3Jun Lu41Department of Paediatrics, Affiliated Hospital of Guangdong Medical UniversityDepartment of Paediatrics, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Central South UniversityDepartment of Paediatrics, The 958 Hospital of the People’s Liberation Army1Department of Paediatrics, Affiliated Hospital of Guangdong Medical University1Department of Paediatrics, Affiliated Hospital of Guangdong Medical UniversityAbstract Rare diseases present a significant economic burden on patients, families, and healthcare systems worldwide. As the prevalence of these diseases rises in China, data regarding their impact, specifically in Hainan Province, is scarce. Thus, this study aims to evaluate insurance coverage, economic costs, and the factors contributing to the burden of rare diseases in Hainan. We employed a bottom-up approach to analyse the prevalence and economic burden from 2019 to 2023, utilising data from the Hainan Provincial Health Commission Databases. We assessed insurance coverage as well as expenditures related to hospitalisation, diagnostics, medications, surgery, and out-of-pocket costs. Of 4,975 patients diagnosed with 99 distinct rare diseases, 83.01% were insured. From 2019 to 2023, the number of patients increased from 760 to 1,328, while economic costs surged from 34.26 million CNY (US$ 4.89 million) to 64.74 million CNY (US$ 8.86 million). Thalassemia major, one of the most prevalent conditions, generated the highest costs. Hospitalisation expenses accounted for 49.16% of the total costs, with out-of-pocket expenses averaging 17.52%. The findings reveal a significant economic burden associated with rare diseases in Hainan, highlighting the necessity for targeted policy interventions. Furthermore, additional research is needed to refine estimates of this economic burden.https://doi.org/10.1038/s41598-025-97836-0Rare diseasesEconomic costDisease burdenPrevalenceMedical insurance
spellingShingle John Sieh Dumbuya
Xiuling Chen
Lin Deng
Bashir Ahmad
Jun Lu
A retrospective study of insurance coverage status and economic cost of rare diseases in Hainan Province
Scientific Reports
Rare diseases
Economic cost
Disease burden
Prevalence
Medical insurance
title A retrospective study of insurance coverage status and economic cost of rare diseases in Hainan Province
title_full A retrospective study of insurance coverage status and economic cost of rare diseases in Hainan Province
title_fullStr A retrospective study of insurance coverage status and economic cost of rare diseases in Hainan Province
title_full_unstemmed A retrospective study of insurance coverage status and economic cost of rare diseases in Hainan Province
title_short A retrospective study of insurance coverage status and economic cost of rare diseases in Hainan Province
title_sort retrospective study of insurance coverage status and economic cost of rare diseases in hainan province
topic Rare diseases
Economic cost
Disease burden
Prevalence
Medical insurance
url https://doi.org/10.1038/s41598-025-97836-0
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